新生儿脑膜瘤围手术期管理:病例系列。

IF 2 4区 医学 Q2 PEDIATRICS Children-Basel Pub Date : 2024-10-07 DOI:10.3390/children11101219
Filla Reviyani Suryaningrat, Sindy Irenewati, Mirna Sobana, Fiva Aprilia Kadi, Aris Primadi, Tetty Yuniati
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引用次数: 0

摘要

背景:脊髓脊膜膨出症(MMC)是一种影响中枢神经系统的先天性畸形,被归类为神经管缺陷(NTD)。在未经治疗的病例中,出生后六个月内的死亡率为 35% 至 70%。在全球范围内,该病的发病率估计为每 1000 例活产 0.8 至 1 例,亚洲和社会经济地位较低的群体发病率较高。这种疾病带来了巨大的治疗成本和终身残疾负担。在欠发达国家或发展中国家,诊断延误会导致感染和破裂等并发症。虽然子宫肌瘤破裂是一种罕见的并发症,但这方面的研究报道却很有限。本研究旨在讨论 MMC 破裂的围手术期处理和潜在并发症:本研究介绍了四例由私立医院转诊并由印度尼西亚西爪哇 Hasan Sadikin 综合医院管理的 MMC 破裂病例。每位患者在到达医院后都接受了临床评估和诊断,随后进行了围手术期治疗,并对治疗过程中出现的并发症进行了处理:结果:四例病例中有三例患儿入院时已超过 24 小时。三个病例位于腰骶部,一个病例位于胸部。入院时,我们观察到的临床表现包括小头畸形、胎龄小(SGA)和先天性马蹄内翻足(CTEV)。我们还发现了一些并发症,包括伤口裂开、呼吸衰竭、脑积水、腿软、脑膜炎和术后败血症:结论:围手术期管理至关重要,需要多学科方法和精确的手术技术来减少严重并发症。
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Meningomyelocele Perioperative Management in Neonatal: Case Series.

Background: Myelomeningocele (MMC) is a congenital malformation affecting the central nervous system, categorized as a neural tube defect (NTDs). In untreated cases, the mortality rate within the first six months of life ranges from 35% to 70%. Globally, its incidence is estimated 0.8 to 1 per 1000 live births, and rates are higher in Asia and lower socioeconomic groups. This disease imposes a significant treatment cost and burden due to life-long disabilities. In less developed or developing countries, delays in diagnosis can lead to complications such as infection and rupture. Although rupture is a rare complication in MMC, there are limited studies that have reported it. This study aims to discuss the perioperative management and potential complications of ruptured MMC.

Method: This study presents four cases of ruptured MMC that were referred from private hospitals and managed by Hasan Sadikin General Hospital in West Java, Indonesia. Each patiens underwent a clinical assessment and diagnostic evaluation upon arrival, followed by perioperative theraphy and management of any complications that emerged during treatment.

Result: In three of the four cases, the children were over 24 h old when they were admitted to the hospital. Three cases were located in the lumbosacral region while one case was located in the thoracic region. Upon arrival, the clinical presentations we observed included microcephaly, small for gestational age (SGA) and congenital talipes equionavrus (CTEV). And we found several complications included wound dehisence, respiratiory failure, hydrocephalus, leg weakness, menigitis and sepsis after surgery.

Conclusions: Perioperative management is highlighted as vital, necessitating a multidisciplinary approach and precise surgical techniques to mitigate severe complications.

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来源期刊
Children-Basel
Children-Basel PEDIATRICS-
CiteScore
2.70
自引率
16.70%
发文量
1735
审稿时长
6 weeks
期刊介绍: Children is an international, open access journal dedicated to a streamlined, yet scientifically rigorous, dissemination of peer-reviewed science related to childhood health and disease in developed and developing countries. The publication focuses on sharing clinical, epidemiological and translational science relevant to children’s health. Moreover, the primary goals of the publication are to highlight under‑represented pediatric disciplines, to emphasize interdisciplinary research and to disseminate advances in knowledge in global child health. In addition to original research, the journal publishes expert editorials and commentaries, clinical case reports, and insightful communications reflecting the latest developments in pediatric medicine. By publishing meritorious articles as soon as the editorial review process is completed, rather than at predefined intervals, Children also permits rapid open access sharing of new information, allowing us to reach the broadest audience in the most expedient fashion.
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